Hospitalist program helps streamline patient care at The Scarborough Hospital

Access to a physician along with an interdisciplinary team of health-care professionals was very “reassuring” for patient Diane Ranger, admitted to a general medicine unit at The Scarborough Hospital General campus in mid-August and discharged in early December.

“Even at 3 a.m. when I told the nurse I couldn’t sleep or I was in pain, and if the medication wasn’t on my chart, they contacted the doctor and in less than 15 minutes, I had an answer. I don’t know what else they could have done for me, to be honest,” Diane says. “I wasn’t the easiest patient at the beginning because I wasn’t well, but everybody hung in with me and they couldn’t have been any more helpful.”

Diane was experiencing a patient care model that focuses on an interdisciplinary team of health-care professionals. It’s called the hospitalist program, and it is having a positive impact on two TSH medicine units.

The program was introduced last July to the two units which were identified as the most appropriate to transition into the hospitalist model. One of the fastest growing models of care delivery in North America, the hospitalist program addresses four key areas of care: patient flow, timely service, quality of care and volumes.

The team includes a clinical resource leader, hospitalist (internist physician), a patient care manager, charge nurses, assigned nurses, pharmacists, occupational therapists, dietitians, physiotherapists, social workers, speech and language pathologists and a Community Care Access Centre case manager.

“Each morning, the team meets for bullet rounds to review each patient’s care plan,” explains Nancy Veloso, TSH Patient Care Director for the Medicine Program. “We’re together, talking and focusing on the patient, and that’s really what the hospitalist model is designed to do – bring us all together to do what we each do best.

That sentiment is shared by Tabatha Bowers, Interim Patient Care Manager on one of the units.

“The hospitalist model enhances and better connects the interprofessional team to best meet the needs our patients,” Tabatha adds.

A key benefit of hospitalist model is the expertise of the physician group.

“A unique element of the program is having that physician availability on that unit, dedicated solely to that unit during that day,” Nancy explains. “There are no other competing priorities: inpatients are the priority for the hospitalist and the interprofessional team.”

One of the four hospitalists, Dr. Anna Lukowski, says it has been a pleasure working with a “true multidisciplinary team.”

“The aim to have the bedside nurses and the charge nurses provide valuable input to patient care, along with the other members of the team, has meant we have been able to provide high quality care to our patients,” she says. “And that’s really what we’re here to do.”

The official launch on December 1 recognized the success of the model, “and brings these two medicine units to a unique place in how we can continue to improve and look at new opportunities for how we provide patient care,” Nancy adds.

“Preliminary results indicate that these two units have demonstrated the most improvement on patient satisfaction surveys related to care planning, communication with physicians and the team, as well as coordination and continuity of care.”

The hospitalist model is working well for the staff, too.

“The staff quite like having someone on the floor all the time to troubleshoot, problem-solve and facilitate for them,” explains Ann Sideris, Clinical Resource Leader for one of the units. “They’re busy everyday providing patient care, so if something comes up or there’s a crisis on the floor, the hospitalist is based on the unit and is therefore more accessible.”